Provider Demographics
NPI:1083905442
Name:CARDIOVASCULAR SPECIALISTS OF TEXAS, P.A.
Entity Type:Organization
Organization Name:CARDIOVASCULAR SPECIALISTS OF TEXAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUTICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-615-6224
Mailing Address - Street 1:7215 WYOMING SPGS
Mailing Address - Street 2:BUILDING 1 SUITE 100
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4312
Mailing Address - Country:US
Mailing Address - Phone:512-807-3160
Mailing Address - Fax:
Practice Address - Street 1:613 ELIZABETH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2220
Practice Address - Country:US
Practice Address - Phone:512-807-3150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty